High Dose Methylprednisolone in Fulminant Progressive Quadriparesis with Optic Neurites: The Marburg Variant

Marburg described an acute variant of Multiple Sclerosis (MS) which was rare with a fulminant demyelinating progressive course with multiple lesions, predominantly in young adults, leading to severe disability and death within a year of onset. The disease was associated with an Antibody-mediated process, acute fulminant course and typical MRI findings which are diagnostic of the disease. High-dose glucocorticoids, cyclophosphamide and mitoxantrone have shown good response to treatment. The malignant form of MS accounts for less than 4% of the incidence. Here the patient had no history or sign of infectious, metabolic, or vascular pathology and thus the diagnosis of Marburg’s variant was made by exclusion. The Marburg variant is rare and needs a high index of suspicion. In the future, studies of patients with tumefactive demyelinating lesions are necessary for early diagnosis, greater understanding of the disease and for the development of therapeutic strategies.